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目的观察不同胎龄的新生儿视网膜发育情况,探讨胎龄与早产儿视网膜病变(ROP)的关系及ROP的影响因素。方法 78例不同胎龄新生儿(胎龄28～30周8例,30+1～32周16例,32+1～34周18例,34+1～37周13例,37+1～41周23例),于出生第1-3天检查视网膜血管发育情况,并于出生后4～6周复查眼底,观察ROP发生情况,并分析胎龄、出生体质量、氧疗时间、出生窒息、HIE、颅内出血、呼吸窘迫、高胆红素脑病、母亲产前使用激素、出生后应用肺表面活性物质及母亲妊娠高血压病等因素与ROP发生的关系。结果胎龄28～30周8例中7例(占87.5%)视网膜发育不成熟,30+1～32周16例中9例(占56.3%)视网膜发育不成熟,32+1～34周18例中3例(占16.7%)视网膜发育不成熟,34+1～37周13例中仅1例(占7.6%)视网膜发育不成熟,37+1～41周23例均发育成熟。出生时视网膜发育不成熟的20例新生儿中,8例(占60%)于出生后4～6周复查时发现ROP,而出生时视网膜发育良好的新生儿无一例发生ROP。胎龄、出生体质量、氧疗时间、母亲产前应用皮质激素、呼吸窘迫、使用肺表面活性物质与ROP的发生有关。而出生窒息、HIE、颅内出血、高胆红素脑病等与ROP的发生无明显相关性。结论胎龄、出生体质量、氧疗时间、母亲产前应用皮质激素、呼吸窘迫、使用肺表面活性物质与ROP的发生有关。胎龄越小、出生体质量越低,视网膜发育越不成熟,ROP发生率越高。
Objective To observe the development of retina in neonates with different gestational age and explore the relationship between gestational age and retinopathy of prematurity (ROP) and the influencing factors of ROP. Methods: A total of 78 gestational age neonates with gestational age ranging from 28 to 30 gestational weeks, 16 from 30 + 1 to 32 weeks, 18 from 32 + 1 to 34 weeks, 13 cases from 34 + 1 to 37 weeks, 37 + 1 to 41 Week 23 cases), retinal vascular development at 1-3 days of birth and retina 4 to 6 weeks after birth to observe the occurrence of ROP, and analysis of gestational age, birth weight, oxygen therapy time, birth asphyxia, HIE, intracranial hemorrhage, respiratory distress, high bilirubin encephalopathy, maternal prenatal steroid use, postnatal application of pulmonary surfactant and maternal pregnancy-induced hypertension and other factors and ROP. Results In the 28-30 weeks gestational age, 7 cases (87.5%) had immature retina, 9 cases (56.3%) in 16 cases between 30 + 1 and 32 weeks, retinal immaturity, 32 + 1-34 weeks Three cases (16.7%) developed immature retina. Only one of 13 cases (7.6%) from 34+ 1 to 37 weeks developed immature retina, and 23 cases developed from 37 + 1 to 41 weeks. Of the 20 neonates with immature retina at birth, 8 (60%) developed ROP at 4 to 6 weeks after birth and none developed ROP at birth with well-developed retinas. Gestational age, birth weight, oxygen therapy time, maternal prenatal corticosteroids, respiratory distress, the use of pulmonary surfactant and the occurrence of ROP. Birth asphyxia, HIE, intracranial hemorrhage, high bilirubin encephalopathy and the incidence of ROP no significant correlation. Conclusions Gestational age, birth weight, duration of oxygen therapy, maternal prenatal corticosteroids, respiratory distress, and the use of pulmonary surfactant are associated with the development of ROP. The smaller the gestational age, the lower the birth weight, the more immature the retina and the higher the incidence of ROP.